"What is kind of exciting from our study is we prevented those children who would have had an unhealthy weight in the first place and helped them have a healthier weight, which sets them up better for health throughout their lives," said co-lead researcher Dr. Eliana Perrin, a professor of primary care at the Johns Hopkins University Schools of Medicine, Nursing and Public Health in Baltimore.
About 1 in 5 school-aged kids were obese in 2017-2018, and these rates are expected to have increased since the pandemic, researchers said.
In a prior study, Perrin and her colleagues found that in-clinic counseling improved healthy growth in newborns up to 18 months of age, but not through the age of 2.
That might be because pediatric office visits become less frequent past a child's first year of life, the researchers reasoned.
Given that, they created a follow-up study focusing on using digital technology to continue providing health and diet counseling for new parents, even if they're no longer dropping by a doctor's office.
"We found that parents are eager for more information to help their children grow up healthy, and the vast majority of parents own smartphones," Perrin said in a Hopkins news release.
For the study, researchers recruited nearly 900 parent-infant pairs between October 2019 and January 2022.
At the start, all babies were 21 days or older, born near or at term, had a healthy weight and had no chronic health problems that would promote weight gain.
All of the parents received the in-clinic counseling, but half also received personalized, interactive text messages from a fully automated system.
These texts supported and promoted healthy behaviors, such as fewer sugary drinks or less screen time. These goals were texted in English or Spanish every two weeks until the kids reached age 2.
Parents receiving the texts also had access to a web-based "dashboard" designed to help them track healthy goals,
By age 2, only 7% of the text-message group's children were obese, compared with nearly 13% of the clinic-only group -- a 45% relative reduction, researchers calculated.
This study, published Sunday in the Journal of the American Medical Association and presented simultaneously at the Obesity Society's annual meeting in San Antonio, might be one of the first ever to prevent early childhood obesity, Perrin said.
What's more, the texts had a greater effect on children at higher risk of obesity -- those in homes with food insecurity, Black and Hispanic children, and kids with parents who have less health literacy.
"If we can prevent obesity in these children at greatest risk, we can also create better health equity in the future," Perrin noted.
The U.S. Centers for Disease Control and Prevention has more on preventing childhood obesity.